Rodrigues Paula Maria Fernandes, Delerue-Matos Alice
Department of Sociology, University of Minho. Campus de Gualtar, 4710-057, Braga, Portugal.
Arch Gerontol Geriatr. 2025 Mar;130:105730. doi: 10.1016/j.archger.2024.105730. Epub 2024 Dec 21.
This systematic review aimed to evaluate the independent and joint effects of social exclusion in three specific domains-economic, social relations, and civic participation-on the cognitive health of middle-aged and older adults. Longitudinal studies from January 2000 to October 2023 were identified via Web of Science, Scopus, and PubMed, with sixty-five studies meeting inclusion criteria. The quality of the studies was assessed with Newcastle-Otawa Scale. Analysis revealed a strong association between economic exclusion and cognitive decline, with most studies indicating a significant negative impact. Ten studies found a positive link between volunteering and cognitive health for civic participation, while eight did not, showing mixed evidence. In social relations, most studies connected loneliness, social isolation, smaller social networks, reduced contact with family and friends, lower engagement in activities, and negative social interactions with cognitive decline. Notably, one study found that older adults experiencing social exclusion in multiple domains simultaneously face even greater cognitive decline. In summary, this review shows that social exclusion in economic, social relations, and civic participation and all together domains is associated with greater cognitive decline in older adults.
本系统评价旨在评估经济、社会关系和公民参与这三个特定领域的社会排斥对中老年人认知健康的独立影响和联合影响。通过科学网、Scopus和PubMed检索了2000年1月至2023年10月的纵向研究，有65项研究符合纳入标准。采用纽卡斯尔-渥太华量表评估研究质量。分析显示经济排斥与认知衰退之间存在密切关联，大多数研究表明存在显著负面影响。十项研究发现公民参与方面的志愿服务与认知健康之间存在正相关，而八项研究未发现，结果不一。在社会关系方面，大多数研究将孤独、社会隔离、较小的社交网络、与家人和朋友的联系减少、活动参与度降低以及负面社会互动与认知衰退联系起来。值得注意的是，一项研究发现，在多个领域同时经历社会排斥的老年人面临更大的认知衰退。总之，本评价表明，经济、社会关系和公民参与以及所有这些领域的社会排斥都与老年人更大程度的认知衰退有关。
